Vaca Leche

OKAY. YOUR TURN.

CMS is taking public comments on the new lactation CPT codes until September 14. You do NOT have to be an IBCLC to comment.

How to do it:

1. Go to Regulations.gov
2. Search CMS-2026-2377
3. Click Comment- it’s a blue box at the top.
4. Say you are commenting on Section (46), Lactation Care Services, CPT 978XX & 978X1
5. Tell them YOUR experience.

IBCLCs: Tell them what your credential required, what your visits actually involve, how long they take, and whether you are an RN or non-RN IBCLC.

Healthcare providers: Tell them why you refer to IBCLCs and why your patients need access to this care.

Parents: Tell them why you needed an IBCLC, what happened during your visit, what your IBCLC identified, and what that care meant for your family.

It does not need to be long. Please don’t copy mine. Your story is more powerful in your own words.

We have a chance to get dedicated lactation CPT codes. I want them. I want insurance coverage. I just want us to get this right.

Deadline: September 14. Go comment. Then send this to someone else who should, too.

I could make this easier on myself by simply not accepting insurance.

But I don’t want to.

I believe lactation care is healthcare, and I believe families deserve to use the insurance benefits they pay for.

I also refuse to let an insurance company determine how much time a family deserves with me.

Those two things should not be incompatible.

Right now, lactation is finally getting dedicated CPT codes. That could be a HUGE step forward. But we have an opportunity, right now, to make sure the people making these decisions understand what comprehensive lactation care actually looks like and what happens when reimbursement doesn’t support it.

Because when independent lactation practices can’t afford to accept insurance, the problem doesn’t disappear.

The cost just gets shifted to families.

And eventually, specialized lactation care becomes something only families who can afford to pay out of pocket can access.

I don’t want that future.

Honestly, continuing to fight for insurance-covered lactation care is one of the biggest reasons I went back to graduate school.

So now I need your help.

CMS is accepting public comments through September 14.

If an IBCLC has made a difference for your family, you don’t need to understand CPT codes or RVUs to comment.

Tell them your story.

What brought you to lactation care?
What happened during your visit?
How much time did your IBCLC spend with you?
What did they notice that hadn’t been identified before?
Did they refer you somewhere else?
What changed for your family?
What would losing access to that kind of care mean?

Your story is the evidence of why this care matters.

I’ll put exactly where and how to comment in the next post.

I don’t usually talk about my résumé.

But before I ask you to help me fight for lactation care, I need you to understand what that care can actually look like.

Sometimes lactation care is helping a baby latch.

Sometimes it’s realizing a baby isn’t getting enough milk and needs immediate medical care.

Sometimes it’s recognizing that feeding is only one piece of a much bigger picture involving maternal health, infant health, mental health, development, safety, finances, and access to care.

And sometimes my job is knowing that I’m not the person a family needs next, and getting them to the right person quickly.

That’s why I believe so strongly that lactation care exists on a spectrum, and that comprehensive lactation care deserves to be recognized as skilled healthcare.

Right now, decisions are being made about how that care will be defined and valued.

And I’m going to need your help.

If you’ve worked with me, you’ve probably learned I love when babies get body work and I love myofascial release therapy for them. I know it makes big changes in kiddos quickly. What I didn’t know… was how much I needed it. RoOTed•Shauna Fox-Hamilton•Myofascial Release•OT•Sioux Falls is a magician and I can’t wait to do some more work with her! Ask me any questions you have about this type of body work and why I love it for babies!

Rapid fire paci review…. But not pretend I’m David Rose from Schitt’s creek. Gosh I miss that show😂. Pacifiers are a tool and if what you have is working for you keep on keeping on. But some are better than others. Also, I really should have worn black for this😂. David would never call this color purple either, it would be Dusty Lavender or something ridiculous.

Get nerdy with me!

In a manner of three weeks, I had a grad student discussion board conversation, a conversation with colleagues and multiple patients ask some variation of the same question. Does antenatal expression cause oversupply?

I had to know where this was coming from and what evidence there was behind it. I found both!

Right now, we do not have evidence that antenatal colostrum expression causes hyperlactation.

But there is a proposed mechanism that makes this a really interesting question.

During pregnancy, prolactin is already elevated, but high progesterone prevents full secretory activation. One 2026 systematic review discusses the hypothesis that breast stimulation during pregnancy may increase mammary prolactin receptor activity. Theoretically, that could “prime” the breast to respond more strongly to prolactin once progesterone falls after delivery. This is just something they propose in the study as to why we find that onset of copious milk happens quicker in patients that express antenatally.

There is also a 2025 publication describing one clinical observation of hyperlactation following antenatal colostrum expression. That is worth paying attention to, but one observation cannot tell us whether antenatal expression caused it.

So right now we have:

A biologically plausible proposed mechanism.

Evidence of some effect on early lactation.

One reported clinical observation of hyperlactation.

What we do not have is evidence connecting those things and demonstrating that antenatal expression causes pathologic oversupply.

Did you express while pregnant? What was your supply like?

September is here! And lots of babes are about to join us!

September holds 9/10 most common birthdates in the United States. September is the most common birth month in South Dakota… August is the second most common and that was wild, friends!

This September, I begin clinical placement for my family nurse practitioner degree. I have a wonderful first preceptor placement and may get to see some familiar faces there and learn from some incredible people…. But that means I will be away from my clinic more. October is when I have several teaching gigs on top of clinical…

Why do I tell you this? If you think you’re going to need support, book a prenatal. Do it now. And if your baby gets here and you think want support, book the first spot you can find! I guarantee that I will see every prenatal person if they desire within the first 5 days. I have spots blocked off for every one of you! But those spots are dwindling FAST. My bleeding heart wants to see all the mamas, but it will not be possible. I’ve got wait lists created in preparation, but pleeeeease reach out the second you need help, preferably before baby even gets here!

Also, I know what you did last December 😘😜

You’ve heard what’s happening. Now I need your help. 🤍

Insurance companies expect providers to push back on reimbursement changes.

But they need to hear from families, too.

If insurance-covered lactation care helped you feed your baby, made support financially accessible, or simply gave you somewhere to turn when feeding wasn’t going as planned—please help protect that access for the families coming after you.

There’s a Change.org petition calling for sustainable insurance reimbursement for lactation care so IBCLCs can continue accepting insurance and families can continue accessing the benefits they’ve been promised.

Please sign it. Share it. Send it to another family who understands why this care matters.

Because having a lactation benefit on paper means very little if there’s no one available to provide it.